Drugs and surgery for GERD have become car food warmer universal and standard treatments for GERD: h

This is the third article of a four part series on acid reflux and GERD. Read t he first article on the underlying cause, t he second article on the myths of H. pylori and low stomach acid being the major causes and the final article on the myths of trigger foods and GERD diet that works without drugs.
Surgical procedures seek to improve the barrier between the esophagus car food warmer and stomach by strengthening the lower esophageal sphincter. In the Nissen Fundoplication procedure for example, the surgeon pulls up the very top part of the stomach and tightly secures car food warmer it around the esophagus with sutures effectively tightening the LES. Though this procedure does not treat the underlying cause of acid reflux, when performed right, it can minimize reflux. But a fundoplication involves invasive surgery which carries the risks of infection and complications. And the truth is, many people who have had the operation continue to have symptoms and must remain on acid reducing drugs. One of our readers, N. Baily s experience car food warmer (third review from the top) illustrates this point. Also, repeat operations may be needed because the surgical tightening can loosen up over time.
One significant problem with LES tightening procedures which I touched upon in my first article is the side effects including: stomach pain diarrhea difficulty swallowing inability to belch or vomit bloating and flatulence- from trapped intragastic and intestinal gas [i]
The second approach is based on the idea that most GERD symptoms and tissue damage are caused by stomach acid, as opposed to bile, enzymes or bacteria which may also be present. By the way, stomach acid itself isn’t the problem as long as it stays in the stomach. car food warmer Regardless, there has been a virtual explosion in the development of medicines attacking stomach acid.
H2 antagonists limit the release of acid from parietal cells that line the stomach by blocking the production of histamine. H2 blockers are much more powerful than antacids and were actually the first ever blockbuster drugs.
More recently, even more powerful proton pump inhibitor car food warmer (PPI) drugs were developed. PPIs literally shut down acid production in parietal cells inducing profound and sustained suppression of stomach acid. PPIs are now one of the most commonly prescribed drugs accounting for 95 million car food warmer prescriptions in 2009 according to an FDA review . Most PPIs (and H2 blockers) are now available over the counter car food warmer as well.
Though newer PPIs are very potent, they are still not able to fully control symptoms in almost 50% of the people who take them. [ii] This has led to renewed car food warmer efforts to develop even stronger car food warmer acid suppressing drugs. One recent journal article noted the shortcomings of these agents being incomplete acid suppression in the majority of patients . [iii] To overcome this shortcoming , doctors now routinely prescribe both PPI and H2 blocker drugs together in an attempt car food warmer to completely shut down stomach acid 24/7.
I attended the Digestive Disease Week meeting in 2013 where gastroenterologists and other health professionals from around the world get together each year. One issue that even concerned many GI doctors (they set up a special session to discuss the problem) was the excessive car food warmer use of high dose PPI drugs and the increasing practice of combining car food warmer PPIs with H2 blocker drugs. I agree. There is reason for grave concern.
We now know clearly that reducing stomach acid with drugs: Does not address car food warmer the root cause of GERD Does not provide adequate symptom relief for almost half the people being treated Diminishes vitamin B12 absorption (risk of anemia) and likely other vitamins Diminishes minerals absorption car food warmer including calcium (risk of bone fractures), magnesium (risk of serious cardiovascular, car food warmer neurological problems and also bone health) and iron (risk of anemia) Increases risk of bacterial overgrowth in the small intestine and stomach since stomach acid is part of our bacterial control system Increases the risk of C diff and other GI infections likely because our acid barrier to outside pathogens is missing car food warmer Increases the risk of pneumonia likely from reflux car food warmer of gut microbes into the lungs
Drugs and surgery for GERD have become car food warmer universal and standard treatments for GERD: however, they have several shortcomings: They don t address the underlying cause of acid reflux They don t fully address symptoms for many people They carry significant side effects and health risks
Stay tuned for the final article where I address dietary approaches to GERD. I will challenge car food warmer this 2013 statement by the American Medical Association s Continuing Medical Education (CME) program for doctors and gastroenterologists:
[i] Vakil N, Shaw M, Kirby R. Clinical effectiveness of laparoscopic fundoplication in a US community. Am J Med. 2003 Jan;114(1):1-5. Klaus A, Hinder RA, DeVault KR, Achem SR. Bowel dysfunction after laparoscopic anti reflux surgery: incidence, severity, and clinical course. A